Insurance Receivable Specialist I

Exciting Opportunity at MSK:Insurance Receivable Specialist I

At Memorial Sloan Kettering (MSK), the Insurance Receivable Specialist I plays a critical role in ensuring accurate reimbursement and financial integrity. This position supports the Revenue Cycle Management - Patient Accounts department by resolving insurance balances, analyzing claims, and partnering with payors to drive timely payment outcomes within a high-performing oncology care environment.

Role Overview:

• Represent Revenue Cycle - Patient Accounts in resolving insurance balances for inpatient and outpatient accounts

• Communicate directly with insurance carriers via portals, phone, email, and correspondence to drive claim resolution

• Investigate and resolve claim denials, underpayments, and delayed reimbursements

• Submit appeals and supporting documentation to ensure proper reimbursement outcomes

• Interpret and apply internal billing terminology, workflows, and escalation protocols

• Collaborate with internal teams to coordinate account resolution and share updates

• Maintain accurate and timely documentation of all account activity within Epic and other systems

• Update insurance and demographic information, ensuring claims are corrected and resubmitted when needed

• Identify payer trends or recurring issues and escalate appropriately to leadership

Key Qualifications:

• 2-4 years of relevant experience in healthcare revenue cycle environment required

• Experience working with insurance claims, billing, or accounts receivable processes

• Knowledge of EHR medical claims modules like Epic, including Resolute Hospital Billing, Professional Billing, or Tapestry preferred

• Familiarity with oncology-specific coding (ICD-10, CPT, HCPCS/J-codes for chemotherapy and supportive drug services) preferred

• CRCR (Certified Revenue Cycle Representative), CPAM, or CHFP certification preferred

Core Skills:

• High attention to detail and accuracy in documentation and claims resolution

• Effective communication skills for interacting with insurance carriers and internal stakeholders

• Problem-solving mindset with persistence in resolving complex insurance issues

• Organizational skills to manage high-volume workloads and meet productivity expectations

Additional Information:

• Schedule: 8:00 AM - 4:00 PM EST, Monday - Friday with option to change to 9:00 - 5:00 PM EST after training period and able to perform independently

• Location: Remote with flexibility to come on-site once per year in the summer for annual meeting, ideal candidate will be within NYC metro area in case needs change to a rotating schedule to be on-site on some days

• Reporting to: Supervisor, Revenue Cycle - Patient Accounts

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